Mycosis of the feet: Etiological aspects, pathogenetic mechanisms and therapeutic strategies

This article presents current data on the etiopathogenesis of athlete’s foot, the clinical characteristics of the disease, and focuses on the persistence of fungal infections in the modern world. Most often, athlete’s foot is caused by dermatophytes, primarily of the genus Trichophyton. In recent years, the biology of Trichophyton rubrum and Epidermophyton flocсosum has been enriched by the development and application of new molecular genetic methods: in particular, the genomes of dermatophytes have been sequenced and compared. The cellular and biochemical characteristics of human infection with T. rubrum, T. interdigitale, and E. floccosum play an important role in understanding the differences in the incidence of athlete’s foot due to various fungal species. This article describes in detail the process of fungal invasion of human skin and identifies the mechanisms by which fungal colonization and the inflammatory response with characteristic clinical manifestations. The main mechanisms of resistance of fungal infections of the feet are indicated. We describe cases of athlete’s foot in various clinical presentations, including those associated with nail lesions. Much attention is paid to the specifics of external therapy using sertaconazole cream, considering its multifaceted activity, and the need for combination therapy with systemic antifungal agents, in cases of skin lesions with pronounced inflammatory phenomena, or external ones, in the form of varnish, in case of combined lesions of the foot skin and nails (if less than 1/3 of the nail plate is affected). This article presents cases demonstrating the high effectiveness of the therapeutic measures taken, the elimination of clinical symptoms, and etiological cure. There are also identified issues of individual prevention, which is an integral part of preventing the development of chronic recurrent fungal infection.

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